Dr. Ramappa was referring not only to the pitcher's willingness to play through the pain of a sutured tendon in his ankle during the 2004 World Series, but two previous procedures on Schilling's right shoulder, in 1995 and '99. The surgeon who performed those operations, Dr. Craig Morgan, reportedly said the latest surgery, which involved three structural repairs or changes, revealed a "best-case scenario" for the 41-year-old pitcher. However, everyone knows a functioning shoulder doesn't automatically lead to effective pitching.
Dr. Morgan told the media Schilling's frayed biceps tendon was separated from its attachment point in the shoulder. The diseased portion was removed and then the tendon was reattached outside the joint. Surprisingly, that may not affect his throwing that much.
"It's more about pain relief," says Dr. Ramappa. "The bicep muscle isn't that involved in generating velocity in a throw."
Dr. Ramappa offers up an example involving quarterback John Elway, who had an inflamed bicep tendon back in 1997.
"It is going to hurt. ... [But] we're talking about a guy who would have to throw a baseball past Major League hitters."
-- Dr. Arun Ramappa
"He had a cortisone shot and then, during a preseason game, he tore his bicep tendon," Dr. Ramappa said. "Not only was he able to play that season, he led the Broncos to the first of two consecutive Super Bowl championships. He said his shoulder felt better after the tendon tore."
Schilling also had a repair done on his labrum, the lip of cartilage which rings the shoulder socket, and a one-stitch fix to his rotator cuff. That might be the best news with regard to the pitcher's possible return.
"Unlike Tommy John surgery on the elbow, which has a good success rate, studies have shown that athletes with extensive rotator cuff damage rarely come back at a competitive level," Dr. Ramappa said. "Less injury is a more hopeful scenario."
But it is still a painful one. Patients sometimes have to sleep in a recliner or even upright because of the post-surgical pain. Stiffness is also a concern.
"It is going to hurt to move the joint, but it has to be done in order to recover full range of motion and function," says Dr. Ramappa. "Remember, we're not talking about a person who wants to carry a briefcase to work and be able to lift it onto a desk. We're talking about a guy who would have to throw a baseball past Major League hitters. "
It's a long rehab, even for desk jockeys, so Schilling will have plenty of time to listen when his body asks, "Haven't you had enough?"
He's the only who can decide, "Not yet."